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Update from SOSORT 2018 – what I learnt about scoliosis

Updates from the SOSORT Conference in Dubrovnik 2018

What did I learn about scoliosis?

Rosemary Marchese – Physiotherapist

I have just returned from the SOSORT conference in Dubrovnik. This was a powerful conference of close to 300 participants from 37 countries, gathered so share the latest research in the world of conservative treatment for scoliosis. Given I spend a great deal of my treating time working with patients with scoliosis, or other complex spine issues, this has been a great investment in time and money. I am so excited to share with you some of the main points I took away from this conference. Many of the points are just confirming what I already knew, but it’s always great to make sure you are on the right track!

1. Schroth therapy is warranted and justified in many cases of adult, adolescent and juvenile cases of idiopathic scoliosis. It can be used to improve posture and improve pain in many cases. In some cases a reduction in Cobb angle may even be seen.

2. Bracing, combined with therapy, is warranted and justified in many cases of adult, adolescent and juvenile cases of idiopathic scoliosis.

3. Despite the guidelines published by SOSORT, there is still a major discrepancy between what is recommended by specialists, GPs, physios, chiros etc. around the world, and what is in the guidelines (most recent update published in 2018). This is hindering the optimal treatment plan for so many patients that could be receiving more optimal care.

4. Compliance with the exercises and, where warranted, bracing, is very important. We will be implementing new and improved ways to monitor and encourage compliance in our clinic.

5. Parents and children need support during this time. For this reason we will have an in-house children’s/family psychologist that will be able to support our staff and patients towards better outcomes.

6. The Rigo-Cheneau brace is able to achieve the best in-brace corrections, and for this reason we will continue to recommend this brace, if and when applicable.

7. Minimising radiation to these patients is important. For this reason we will be incorporating new and improved ways to keep monitoring improvements and/or progression of patients. We will continue to use EOS over Xray.

8. Postural improvements can happen with Schroth therapy, even without a change in Cobb angle. The Cobb angle should not be the only measurement tool to determine improvements in patients. Patients are often disheartened when surgeons only refer to the Cobb angle in regards to improvement.

9. The Risser Score is an unreliable measure for determining growth remaining. Our clinic will now be relying more heavily on the relatively new Risser Plus system, and where possible to obtain, the Sanders hand measurement score.

10. There needs to be a push back towards better screening. There could be a case for returning screening to schools.

This is only a short summary! There is much to implement as a result of this conference and we will start making the small steps required to achieve these improvements. It is an exciting time.

While we appreciate that Schroth is a relatively new concept in Australia, please appreciate that overseas this is not so much the case. We are embarking on a relatively new journey in Australia, and we are dedicated to being able to help children and adults with idiopathic scoliosis to be able to:

> Minimise risk of progression

> Improve posture and postural balance

> Reduce pain

> Reduce risk of pain and need for therapy in adulthood

> Reduce the risk of surgery.

The learning journey never ends. I will be travelling to New York in July to further my studies in Schroth. In the meantime there is constant research and applying new and improved methods to current patients.

Is Schroth an alternative to surgery?

Please understand that we never endorse therapy as an alternative to surgery. There are cases for observation, therapy, therapy and bracing, and indeed there are cases that require surgery. If and when a patient requires surgery then we definitely can provide Schroth as a means of pre-operative and post-operative treatment too. We also appreciate that in some cases surgery is indicated but a patient chooses not to. We have had patients arrive in our clinic requesting Schroth instead. We are very clear in explaining that this is their choice and they should understand the risks. However postural improvements may still be able to be achieved. If they then decide to progress to surgery the therapy can be seen as a suitable ‘pre-op’ option.

If you have any questions about scoliosis or Schroth physiotherapy please feel free to contact one of our friendly staff.